Skip to main content

CCH Rotation Info

CCH Rotation Requirements

1. Prepare
  • Download a copy of Ibook I Introduction to Bedside Ultrasound I, and Ibook Vol II Introduction to Bedside Ultrasound Vol II. A copy is also available for use on the Red Team conference computer.  
  • You can check out a copy of Dr. Cosby's book from Estella, or feel free to use the copy in the red team cabinet for additional reading. 
  • Review your pre-rotation numbers that were sent to you before your rotation. Pay particular attention to the applications you should have already completed in previous years.   
  • Review US Rotation Info prior to orientation. 
2. Orientation - Wednesday
  • 12:30 (following EM Conferences) on your first day, unless otherwise scheduled explicitly. Be prepared to meet with faculty and start scanning! Count on scanning 4 hours today.  
    3. Independent Study - Mixture of SonoSim modules, required reading.
    4. SCAN - Thursday, Friday and Monday
    • 24 hours of scan and q-path time required.
    • Residents must be present for assigned times according to CCH Weekly Schedule page, especially for CCH Ultrasound Scanning Sessions on the weekly schedule and google calendar below. 
    • Any conflicts with the schedule must be discussed in advance with the ultrasound faculty (Dr. Rogers) and scan time made up on evenings or weekends within a reasonable timeframe to be agreed upon with us. 
    • Required minimum of 60 submitted scans for each week on rotation. Ultimately only scans that are submitted, reviewed and found to be technically adequate and accurate (excluding false negatives and false positives) will count towards credentialing. 
      • Focus on applications according to your level of training: 
        • PGY1: eFAST, Renal, GB, Gyne, Ob, Peripheral Venous Access
        • PGY2: Aorta,Thoracic, Ob, Cardiac, DVT 
        • PGY3: Thoracic, Ocular, Ob, ST/MSK
        • PGY4: Advanced Echo, Ob, Procedures
    • Tagging is no longer allowed for submitted scans unless specifically approved by US faculty or on Ob exams.  
    • All exams must be submitted within 8 weeks of the date of the exam to be counted towards credentialing. 
      5. Find your great cases! 
      • All residents must identify two "portfolio" cases to pass the rotation. One must be your best normal images to demonstrate your best skill in image acquisition; the other must be an abnormal (Fast should demonstrate free fluid; renal should demonstrate hydro; gb should demonstrate stones; echo should demonstrate reduced EF). Feel free to bring other great cases to show off! 
        • EM1s - FAST
        • EM2s - Renal or Gallbladder
        • EM3s - Echo 
        • EM4s - Advanced Echo or other interesting case
      • All portfolio cases must be identified prior to image review by adding a comment stating "portfolio normal/abnormal" and shared during the Tuesday academic time together. 
        6. Image Review and Presentations - Tuesday
        • Academic Teaching Time typically begins at 11. Plan to scan a few hours before and after.
        • All residents must be present and prepared for image review. We will review all portfolio images as a group. Make them good!! 
        • EM4s on rotation will be required to give a mini-talk on the topic of the day.
        • All residents will read the assigned reading for journal club discussion and be prepared to participate in our group discussion. 
        • Those finishing the rotation will then have a post-rotation eval and review of all required tests, write ups and the number of exams submitted. All of which need to be completed prior to image review.
        7.  Evaluation
        Course Evaluations will be based upon satisfactory completion of the following:
        • Pre- and Post- Rotation Scan Forms.
        • Completion of 60 technically adequate scans for each week on rotation, feedback confirmed on Q Path.
        • Presentation of your portfolio of "best normal" and one good "abnormal" scan 
        • Completion of assigned quizzes and Test
        • Mini-lecture for EM4
        • We welcome and encourage your participation throughout the year in other teaching venues and academic projects, including:  the resident workshops, US College events, Rush student labs, and intern orientation.  There are many opportunities for resident leadership. Talk to us to take advantage of these opportunities!  

        8. Help Us Help You! Please provide any feedback, questions or suggestions on anything Ultrasound.



        Rules to live by (while on ultrasound):

        Keep the Chair's "BMW" Looking Good During Your Rotation!

        To ensure that we are not spreading germs, please follow these simple US Machine Cleaning and Stocking guidelines here. 

        Always include clinical correlation on your Q-Path worksheets, and view and note results of any corresponding studies ordered and done in ED (CXR for thoracic scans and Echo, CTs and formal ultrasounds when done). Studies without this will be considered technically limited and not given credit for credentialing.


        Key Links


        County Qpath

        SonoSim
        County Gcal
        County Resources
        County New Innovations
        County Course Directors Grade Book



        Contact US Ninja Crew


        Popular posts from this blog

        Consider the Probe 3: So I've found the effusion, now what?

        A 74 y/o F with pmhx of metastatic breast cancer, IDDM, HTN presents after a syncopal episode.  The patient notes that for the past 2-3 days she has been experiencing some lightheadedness and shortness of breath with exertion.  She is presently undergoing chemotherapy (I'd throw in some random chemo drus here, but lets face it, we wouldn't know them anyways...) and radiation.  She notes that she hasn't been eating/drinking very well.  She denies fever, cough, hemoptysis, leg pain/swelling.  She has mild nausea but no abdominal pain. As you peek up at the monitor, you note that the patient’s HR is ~ 135 and her BP is 88/56 .  Her O2 saturation is  99% and the nurse told you that she was afebrile.  Taking a look at this patient, she looks ill-appearing and anxious.  Her extremities are cool to touch.  You quickly decide that Room 33 might not be the best place to manage this patient and that she would be better served in a RESUS station.  As you wheel the patient to RE

        Weekly Fix - Lung Ultrasound!

        Check out the awesome narrated lecture below by EM US Fellow Dr. Damali Nakitende.  Read the Chou article while listening to the podcast .  For more lung US FOAMed fun check out the Thoracic page.

        Consider the Probe Take 2: Coming to Grips with your Fundoscopic Shortcomings....

        49 y/o M with hx of HTN, HLD, IDDM presents with non-traumatic L-sided painless visual loss.  The patient states that several hours prior to presentation he developed blurry vision in his L eye.  On quick examination, there are no signs of trauma.  Visual acuity is 20/120 on the L and 20/40 on the R with normal intraocular pressures bilaterally.  Pupils are briskly reactive without any photophobia or consensual photophobia.  The lids, sclera, conjunctivae are grossly normal and there are no corneal defects with fluorescein staining.  Coming out of the room, you are concerned about this sudden-onset blurry vision.  You remember a short lecture on visual acuity changes that Dr. Schindlebeck begrudgingly gave you in between his posting about sweater vests on Pinterest.  Your differential brings concerning diagnoses including central retinal arterial occlusion (CRAO), central retinal vein occlusion (CRVO), retinal detachment, as well as vitreous hemorrhage.  Now, our patien